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  • Title: Rhodococcus equi infection in transplant recipients: case report and review of the literature.
    Author: Muñoz P, Burillo A, Palomo J, Rodríguez-Créixems M, Bouza E.
    Journal: Transplantation; 1998 Feb 15; 65(3):449-53. PubMed ID: 9484772.
    Abstract:
    BACKGROUND: Rhodococcus equi is an opportunistic pathogen that usually causes infection in immunocompromised hosts, mainly human immunodeficiency virus-positive patients, yet solid organ transplant recipients may be affected as well. Infections in this group of patients have not been sufficiently analyzed. METHODS: We report an R equi pneumonia in a heart transplant recipient and review another 11 cases. RESULTS: Infection appeared a mean of 49 months (range 1-180) after transplantation. Lung was primarily involved in 10 cases (83.3%). The remaining two cases presented with a paravertebral abscess and a purulent pericarditis. Invasive techniques were necessary to reach the diagnosis in nine cases. One patient healed with surgical resection of the lesion; the remaining 11 received antimicrobial agents. Six of them required additional surgical treatment. Three patients died. CONCLUSIONS: Clinicians should consider R equi when evaluating a solid organ recipient with an asymptomatic lung nodule. Microbiology laboratories should be alerted in these cases because it could be mistaken for a contaminant diphtheroid and will not respond to the standard empirical therapy.
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